Following my Heart

by Dr. Brian Kaplan
[Extract from the book Passionate Medicine by kind permission of Jessica Kingsley Publishers.]

Childhood
“Black with milk, please.” said Uncle Louis, our beloved family general practitioner. He had just accepted my mother’s offer of a cup of tea and had been asked whether he wanted it ‘black or white’. It was a typical comment from a warm-hearted man whose affection for our family was obvious. He had brought my mother, my two sisters and me into the world – so he knew us pretty well. We were made to feel special but living in the small seaside town in which I grew up there were many others who were made to feel ‘special’. After a while it started to dawn on me that it was he, Uncle Louis who was special – a special doctor.

But what was so special about him? I guess he had average clinical ability as a physician. No special qualifications, although he did personally deliver a lot of babies. I guess he really loved being a GP, loved being a doctor, loved being able to be of service, just loved. And we were just another family who loved him back. Eventually our lives diverged and we left town, but I was very proud of the letter of recommendation he wrote for me when I applied to become a medical student.

Medical School
So I grew up with only one idea of a doctor. One of a smiling, gentle, helpful and effective man who loved his work. Looking back I can now see that he was the only person I knew who loved his work so much. It was this enthusiasm for the job and the love of his patients that made me want to become a doctor.

Getting in to medical school was the easy part. I just had to get good grades at school, which wasn’t difficult.When I got there, I learned that the reality of becoming a doctor was very different from my fantasy of what it would be like. I’d followed my heart but not my head and when you do that you don’t always arrive where you expect! If I’d given it any thought, I would have realised that it was totally unrealistic to be expected to be taught how to be a good doctor by a bunch of Uncle Louis’s! And I certainly wasn’t!

I was fortunate enough to be accepted into one of the two best medical schools in South Africa. However my elation soon ended after one year on campus. As soon as we started learning anatomy by having to dissect a cadaver, I began to lose enthusiasm for the whole experience. I now see it as an important part of my education but at the time, dissection seemed a million miles away from the reason I had become a medical student. Committing long, complicated cycles of physiological chemistry to memory was even worse. I simply did not understand the necessity for all this detailed study of cells, tissues and organs. Five years of the six-year programme were awful for me because I couldn’t articulate why I was so unhappy there. After all, I was pursuing my dream of becoming a doctor, wasn’t I? So why was I so miserable? Miserable or not, I still managed to pass every exam without ever having to re-sit one. This was no mean feat considering that I found the material somewhat less than inspiring.

It would take me a decade of two to realize that I was unhappy because I’d entered into the arena of medical science where patients of doctors were effectively treated as objects of science. We were advised to avoid doing this but were taught little but science. That was the problem for me. Had there been some talk of how we were feeling about becoming doctors, how we felt about medical school and all its travails or how we felt about death and disease, things might have been different. Nobody seemed to care about how I felt about anything. Why should they? They had their own careers to nurture. An honest registrar confided to me about how things worked in the major teaching hospital at which I was attending ward rounds: “Everyone here licks the arse of the person above them and kicks the backside of the person below them!” What a place to learn to become a healer! But where else was I to go?

A doctor – young naïve and romantic
After 6 grueling academic years, I finally qualified as a medical doctor. Ahead of me lay the famous housemanship or internship year. These were the bad old days when junior doctors did 110-hour weeks with shifts sometimes lasting 36 hours or more. Strangely enough, things started to feel better. I suppose I had a little independence and could say what I liked to my own patients in my own time!

One ward round remains forever etched in my memory. It was the morning round after being up all night admitting patients to a very busy medical ward. The entourage of white-coated doctors arrived at the bed of a man in his mid-60s admitted for acute asthma. Connected to drips, he wheezed away as his doctor presented the case to the rest of us. He exuded anxiety and fear. A few practical decisions were made about his medical management. Asthma is usually a mild disease but on occasion can be fatal. Treatment options for physicians are limited – so not much to think about, especially when you are practising mechanistic medicine where the mind-body connection, at best is paid lip service. And there were 30 more cases to see before we could get started on the real work of the day. We moved down the row of beds and saw a few more cases. Then our medical registrar whispered to us: “Don’t all look at once,” she said, “but our asthmatic gentleman has made a rather sudden improvement!” So of course everyone looked over to his bed at the same time. Amazingly, he did look a lot better, chatting away to other patients. Then he saw us looking at him and at once he started to huff and puff again. Everyone on the ward round laughed, but was this merely funny? In reality I had just received my first lesson in holistic medicine. I had just seen, first-hand, the incredibly powerful effect the mind could have over the body. But why weren’t we using this? It was a good question; a question that would fuel my journey towards becoming a different sort of doctor altogether. A doctor, not merely a practitioner of medical science. A doctor that related to his patients, even loved them; a doctor like Uncle Louis.

Towards the end of my year as a junior intern, all my friends seemed to be jockeying for positions in the great medical rat race. All talk was about careers and new jobs. Many planned to go abroad. I made no plans, but with growing excitement I knew the end was in sight. I could get out of the clutches of hospital medicine and look for something else. But what?

Yoga, holism and homeopathy – the start of the adventure
I had always been interested in yoga and one day I was browsing in a shop called Aquarius in van der Merwe Street, Hillbrow, Johannesburg. There was a big box of books on sale and one of them had the title, Homoeopathy. I’d heard of homeopathy, mainly used by medical consultants to deride an over-cautious dose of medication. “That’s a homeopathic (with sneer) dose!” What struck me about this book is that a medical doctor had written it. I thought it was just quacks that used this stuff. It was on sale for next to nothing so I bought it and read it. Written by a Dr. Gordon-Ross it told the story of a doctor who had really enjoyed his work as a homeopathic GP. The book was very basic but what made me devour the book in one reading was the sheer love this doctor had for his patients, his work and for homoeopathy. Here was a doctor practicing medicine with passion!

As I got closer to the end of the book, I felt excited and hopeful. A certain energy had been re-awakened in me. It was the energy that had driven me to become a doctor. Whatever this homeopathy was, it resonated with me in a way nothing had done in 7 years of medical training. At the end of the book, which I’d read in semi-trance in one sitting over a few hours, the author invited any young doctor interested in learning more about homeopathy to write to the Faculty of Homeopathy in London. I sent off a letter, my first letter abroad. I didn’t have much. No job, no money, no career and no girlfriend. But I had hope and enthusiasm and somewhere deep inside myself, I felt blessed.

Following my heart – off to London
London was a revelation to me and I’m not talking about medicine. First of all it was wonderful to live in a country that was relatively free instead of a country run by a fearful, paranoid and racist minority government. London seduced me immediately as a wondrous cosmopolitan city, a magical blend of everything good in the world. Naïve perhaps, but for a 25 year old doctor, it’s a good thing to be idealistic when starting out in life. Cynicism can be reserved for one’s later years…

It was the glorious summer of 1982 and when the sun shines, England becomes a truly magnificent country. This is because most of the time a ceiling of dark clouds closes everyone in on this small island. When the skies are blue, infinity becomes available, flowers and pretty girls appear everywhere. People smile a lot more and say, “Isn’t it a nice day?” In South Africa and California, where such days are the norm, you don’t get this raising of mood on a fine day. To appreciate good weather, you need to suffer bad weather most of the time, it seems.

It wasn’t only the weather that cheered me up. I loved the cultural scene especially theatre and stand-up comedy. I went often to see theatre of a quality beyond my wildest dreams. I was so enamoured with the quality of theatre that I got a reputation for using too many superlatives. Shakespeare came alive for me in quite a new way and I even began to feel comfortable with iambic pentameter! Lacking the English touch for understatement I praised everything I saw until one day, the mother in the family with whom I was lodging said: “Brian, they are just actors doing their job. You do your job as a doctor and you may be doing something more important than they.” She had a point but I was unconvinced. There are many good doctors in the world but few excellent actors. Watch television every night and make up your own mind. My fascination with the theatre felt significant but I did not know why.

Homeopathy – treating the whole person
In October 1982, I made my way to the Royal London Homoeopathic Hospital at Queen’s Square. It was autumn and there were beautiful brown leaves everywhere. Time to start studying homeopathy. I was soon introduced to my fellow students. There were eight of us, all doctors with an interesting path that had culminated in the beautiful wood-panelled room of the library of the Royal London Homeopathic Hospital. We would spend the next 6 months together studying homeopathy. Among these doctors was David Owen whose story you can also read here. Alice Greene was a registrar in the hospital having done the same course as us a little earlier. I determined to get stuck in to the subject matter and for the first time in my life I felt what a student is surely meant to feel – enthusiasm for the subject he is studying! Nobody pushed me. I studied out of pure passion and love of the subject. There was an examination waiting for me at the end of six months but I had no anxiety about that. If I could pass exams in subjects that were of peripheral interest to me, then what were the odds on me passing an exam in a subject I loved?

Homeopathy was the main focus, but I was interested in all forms of holistic medicine. I learned some rudimentary acupuncture; naturopathy (including fasting), Bach flower remedies, healing and hypnosis, but homeopathy remained my first love. I really appreciated the respect that homeopathy gave to the patient’s subjective experience of his illness and his life.

Conventional medicine never seem to be interested in how a patient felt about having asthma or any other debilitating illness. It was interested only in objective information, which could lead to an objective diagnosis, which could then be treated with medicines proven to be helpful to that condition by objective scientific tests. In practice this amounted to finding the right pigeonhole in which to put the patient and then applying the medicine usually given to everyone in that pigeonhole.

Now in many situations this is not a bad thing. If you have acute appendicitis you want it objectively diagnosed and treated with the standard treatment all appendicitis sufferers should get – surgery. The same goes for syphilis and pneumococcal meningitis, except in these conditions the treatment is penicillin. I’d spent enough time in the wards to know that there are times when orthodox medicine is capable of miraculous cures. The problem was that in everyday general practice these ‘miracle cures’ were only possible in a small minority of cases. The average patient was suffering from conditions that were not so easily eradicated by objective medical science. At last I was learning a new way of looking at the ‘average patient’ in a way that respected his or her individuality. This is not to say that good orthodox doctors do not respect their patients as individuals. They certainly do and our Uncle Louis was an excellent example of an orthodox doctor with a holistic approach, even though he did not use a holistic tool, like homeopathy which stimulates the body’s self-healing capacity.

Over the years many conventional doctors had described themselves as practising holistic medicine, but without using any form of alternative or complementary medicine. And it’s true; you can do this but you will be limited to a great degree by the tools at your disposal. One may have a whole person approach as an orthodox doctor and love your patients very much, but when it comes to using the tools of your trade, you will have to become objective, diagnose an illness and recommend the appropriate treatment. In my opinion a doctor becoming more holistic in his approach must acquire at least one holistic tool to use in practice. This could be acupuncture, naturopathy, hypnotherapy, counselling, autogenic therapy, meditation, yoga therapy or one of many others. A holistic tool can be defined as a therapeutic intervention aimed at the patient as a whole organism as well as at his or her symptoms. My choice of an holistic tool was homeopathy. I loved the fact that in homeopathy the patient’s subjective account of how he feels and how he got ill is the very essence of the knowledge the doctor needs to acquire in order to make an effective homeopathic prescription. Acupuncturists have the tongue and the pulses to turn to, but classical homeopaths are obliged to do their utmost to relate to their patients’ life stories in order to find the remedy that fits those stories.

In order to do this I began to see a film of my patient’s life story inside my head as he or she began to talk. Of course the film in my head was different to what had actually transpired in the patient’s life, but as I practiced this, I became better at it. I was able to know how accurate I was by asking a few straightforward questions. I studied the material medica (the medicines) of homeopathy every night for six months, as I knew this was the area they would test in the examination for membership of the Faculty of Homeopathy. For once I didn’t have to cram the knowledge into my head in a frenetic last minute rush. This time I knew I would pass and in March 1983, I did.

During my time at the Royal London Homeopathic Hospital, I had many good teachers. All had something to teach me. I learnt about: whole person homeopathy; the history and philosophy of homeopathy; the central text of homeopathy, The Organon; the anthroposophical approach and the fascinating interplay between homeopathy and mythology.

“When the pupil is ready the teacher appears”
It was one consultant in particular who would change the way I saw medicine and myself, forever. Dr. Eric Ledermann had qualified as a doctor in 1932. The very next year, after an unpleasant encounter with the Nazis, he fled Germany for Scotland and managed to drag the rest of his family out in 1939. After re-qualifying as a doctor in Edinburgh, he studied naturopathy and homeopathy intensively. Later he became a psychiatrist and when I met him in 1982 he was a fellow of both the Royal Society of Psychiatrists and the Faculty of Homeopathy. As if all this was not enough, his main area of personal interest in medicine was philosophy of science and medical ethics.

He made me trawl through books on philosophy, psychology as well as many of his own publications. (See www.wholepersonmedicine.co.uk for details of these) This was hard work indeed, but the significance of doing it, was always clear to me. I thought back to second year of medical school where we dissected a dead body six times a week and had to commit long lists of branches of arteries, veins and nerves to memory. At the time, I knew that the punishing detail would neither serve me nor be remembered. Studying philosophy of science with all its jargon (e.g. epistemology, teleology and phenomenology) was tough as writers like Kant and Husserl are not exactly easy reading! Still, I was privileged to be guided through the works of these philosophers, so I didn’t have to read long portions of unintelligible text.

Dr Ledermann was my first mentor as a medical doctor and was as often stern with me as he was totally generous with his time. The main point was that I’d found a teacher whom I could totally respect. It had been a long journey, but there is that old saying: ‘When the pupil is ready, the teacher appears.’

At last I was pushed to ask myself what the doctor-patient relationship was all about. He supervised my cases and by example showed me what stuff a doctor should be made of. Doctors need to have a philosophy when they enter the clinic to see patients. Many doctors would disagree, stating simply that they are guided by ‘common sense’. Ledermann made me laugh by calling this the philosophy of ‘Naïve Realism’!

In the end I found myself most comfortable in the works of the existential philosopher, particularly Karl Jaspers, who was a medical doctor, philosopher and major influence on Ledermann and helped him formulate his own existential approach in psychotherapy.

Dr. Ledermann’s simple existential ethic, which underpins his psychotherapeutic approach, has never left me. Stated simply: All patients have a conscience. Deep within themselves they can distinguish between right and wrong and know what they need to do with their lives. This is axiomatic and the only exceptions are psychopaths. Psychotic patients have a conscience but are obviously limited in their ability to make contact with it. The conscience of the patient is always at least partly unconscious. If it were totally conscious, the patient would know what to do and not consult a psychotherapist! The challenge for a psychotherapist is to help make the unconscious conscience of the patient, conscious. Understanding this was a revelation. The answer to a patient’s problems is already within the patient. What a relief!

This period had profound ramifications on my career as a doctor and homeopath. I began to realise that consultations with patients were not simply a matter of me choosing the correct homeopathic remedy. Sometimes, in consultation, I had felt as if the patient’s job was to empty on to my desk, a whole lot of symptoms in the form of an unformed jigsaw puzzle. It would then become my job to put all the pieces together, see the ‘big picture’ and then prescribe the homeopathic remedy that fitted it. An awesome responsibility for the homeopath and a chance to off-load for the patient. There is nothing inherently wrong with that except that the patient doesn’t have to do much for himself or herself in order to get better. After sitting in on Dr. Ledermann’s clinic for a year, I began to see the whole homeopath-patient relationship in a completely new light. I still felt some pressure to come up with the right remedy, but now I always asked myself two questions during each consultation. ‘What can I do for this person and what can they do for themselves?’ The second question is crucial and empowering for the patient. There is always something a patient can do to help himself or herself. Improve their diet, exercise, relax, meditate, work on relationships etc. etc. Of course, if you have appendicitis or meningitis, surgery and anti-biotics are respectively the usual treatments of choice, but for most people consulting a doctor, there is a something, however small, that they can do for themselves.

A decade or so later, I would find a potent way to motivate patients to do what they needed to do, but I jump ahead of myself…

Talking to patients: Counselling and psychotherapy
After qualifying as a ‘homeopathic doctor’ (MFHom – member of the faculty of homeopathy) I soon realised that I knew very little homeopathy! Sure I had some theoretical knowledge, but would you allow yourself to be operated on by a surgeon who only knew the theory of a particular operation?

I decided I needed more training. As the doctor-patient relationship was always my first love in medicine, I enrolled on a course of Rogerian counselling run by a London University. It was one of the finest things I ever did for myself. Suddenly the therapist-client relationship was centre stage! Rogers’ great contribution to the world of psychotherapy was this: Results in therapy are less dependent on the psychological theory in the mind of the therapist and more dependent on the very presence of the therapist. In particular the therapist should endeavour to bring three qualities to the consulting room. Warmth, Understanding and Authenticity. The problem is that you can’t really act any of these – you have to be them. I grappled with this and found myself making a crucial decision about my career as a doctor. From then on I knew that I would not be doing my job well if I simply walked into the consulting room and made available to the patient everything I’d learned at medical school. That simply wasn’t good enough. Not for me and and not for my patients. No, I would have to make available everything I had learned about this thing we call life. Everything I’d learned from textbooks and everything I’d learned from living itself. Even from painful experiences; especially from painful personal experiences! It was a big decision but one which brought considerable relief to me. At last I felt as if I was heading in the right direction, in the direction of becoming myself. Or as Rogers might put it ‘on becoming a person’.

In addition to this course I also came to hear of the great classical homeopath, Mr George Vithoulkas. Although not a doctor himself, for the best part of 20 years he had supervised a crack team of medical doctors studying homeopathy in Athens. His prowess as an accurate prescriber was legendary. However what impressed me about him was his holistic attitude to homeopathy. He, much more than anyone who had taught me so far, was totally focussed on matching a homeopathic remedy to a whole human being. I studied intensively with him both in Athens and in London and learned a great deal. I liked the way he spoke with patients, making them feel that there was nothing more important in the world than being fully understood by him. The five or six times that I attended seminars on the lovely Greek island of Alonissos on which he lives, will remain forever etched in my mind as inspiring happy times. I made many friends there too and will always be grateful to George for showing me just how holistic an approach homeopathy really is.

After practising a couple of years, I received a very big compliment. One of my teachers from my time at the Royal London Homeopathic Hospital, Dr Marianne Harling, invited me to help on a book she had been commissioned to edit. It was a collection of essays on material medica by the late Dr. Douglas Gibson. I spent several weekends at the home of this gentlewoman of English homeopathy in the sleepy but beautiful seaside town of Bournemouth. It was an honour and a pleasure to work with her and the result was a successful book published in 1987 called ‘Studies of Homeopathic Remedies’. I was credited as co-editor and felt happy at having done something worthwhile. Homeopaths everywhere speak well of this book, but of course the real credit goes to Dr. Gibson!

There’s more to medicine than homeopathy
I continued to study homeopathy and attend seminars and I also became more motivated to learn new ways of helping patients help themselves. I learned about the importance of a healthy diet and exercise. One day a colleague of mine told me that a patient of mine had consulted him and complained that I’d given her too much to do. I looked at the notes and saw that in addition to homeopathy I’d prescribed a strict diet, skin brushing and daily cold showers. And she repays all my hard work by not coming back. So I learned to see things from the patient’s point of view and only prescribed regimens that I thought had a good chance of being carried out! All part of the learning process; all grist for the mill.

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In 1975, as a first-year medical student, I had learned Transcendental Meditation (TM) and benefited a great deal from this powerful technique. I knew that many patients were under a huge amount of stress and that dealing with that stress could only alleviate their condition. I hesitated to recommend TM as I knew that it had religious connections and was headed up by a well-known guru, Maharishi Mahesh Yogi. Although I was no disciple, I did not feel comfortable sitting in a Western medical practice and prescribing something connected to any religion.

My teacher, Dr Ledermann, had mentioned something called Autogenic Training (now called Autogenic Therapy, AT) that was a systematic form of very deep relaxation that had been developed by a Dr. Johannes Schulz in Germany. He didn’t teach me how to do it but I knew that Dr. Alice Greene, one of my homeopathic colleagues, and a co-author of this book was teaching a course. Alice was kind enough to accept me as a pupil on her course and I learned how to achieve a very quiet state of mind and body. I later learned how to teach AT and have used it ever since in my practice.

Statistics show that the great majority of patients consulting GP’s are suffering from complaints either caused or exacerbated by stress. It remains a mystery why, in the light of this well-established evidence, doctor do not teach their patients how to dump stress. In my opinion, the waiting room of every general practice in England could be used to teach AT to patients every night of the week! Crazy? I don’t think so. After all the word ‘doctor’ actually means teacher. Tell patients to relax? They’ve heard it all before. Invite them to relaxation classes? Now they have a choice: Should I do something to help myself or should I change my doctor?

The joy of Belonging: HPTG
One day in 1989 I received a phone call from a doctor called Lee Holland. He, like a few others, and me had fallen under the spell of that maestro of classical homeopathy, George Vithoulkas. He was keen to form a group of doctors who would teach and promote a more classical, whole-person orientated homeopathy. I leapt at the chance and very soon after that the Hompeopathic Physician Teaching Group (HPTG) was formed. We were eight doctors who were itching to pass on this type of homeopathy to others and we were carried through to success on a wave of joint enthusiasm.

At HPTG we achieved much. A decade after we formed, British homeopathy had had definitely swung to the classical, whole-person approach and I believe we had a lot to do with this. Lee Holland’s dream was really coming true when tragically he died in an motorbike accident in 1996. We were devastated but united in the belief that he would have wanted us to carry on the good work. Another two members of the original group left us and suddenly we were five.

From the start we had made a wise decision at HPTG. We employed a group analyst to sit with us for two hours every couple of months. This helped us deal with many issues and our changing personnel. The group continues and it’s honesty and authenticity makes it a part of my life that I will always value enormously. It is a simple process of dropping ones mask and being prepared to talk about ones feelings. This may not seem a lot but it’s a million miles from the way doctors and other professionals normally relate to each other.

When HPTG decided to include veterinary surgeons in our training we were delighted to welcome two veterinary teachers into this group. A lot of vibrant discussions ensued. This helped us all become more empathic towards each other and it feels a privilege to belong to an organisation that functions at this level. Every minute spent relating in this way feels right although we all have our moments of discomfort! When you use your sense of self in medicine, these are the clinical meetings you need to attend! In pure orthodox medicine such meetings would be eschewed as a ‘waste of time’ whereas an X-Ray meeting where everyone looks at radiographs would seem natural and useful. This is the difference between objective and subjective medicine. Conventional medicine is scientific and essentially objective. Homeopathy demands both a subjective and objective approach. The feelings of the homeopath during the consultation often mirror the feelings of the patient and understanding this can be helpful in choosing a medicine. However, the homeopath also needs to be objective in separating himself from the patient and objectively choosing a medicine that suits his patient.

With these fascinating issues in mind we decided to work with a psychotherapy supervisor, Robin Shohet, and this entailed supervision of our clinical cases as well as group work where we dealt with our feelings towards each other. The days spent with Robin were energizing and enjoyable and I realised how important and sustaining this debriefing process was to me. It seemed to epitomise what was missing from my time in medical school and hospital medicine.

In 2000, I had shown Robin, the plan for a book on the process of the homeopathic consultation. Many books had been written about the medicines and theory of homeopathy but little on the type of conversations homeopaths have with their patients. Robin’s suggestion of writing the book as if the reader were in conversation with me, making the relationship between the reader and myself a parallel process to the relationship the homeopath has with his or her patients. This proved to be good advice as when the book was published (The Homeopathic Conversation, Natural Medicine Press, 2001) many people remarked on how they had enjoyed the conversational style of the book. I had been honest in the book about my travels through medical school and hospital medicine into homeopathy and HPTG and it felt good to share this adventure with others on similar journeys.

Health, Humour and Laughter
I’ve always loved comedy. Perhaps that’s why I loved Uncle Louis so much; he made me laugh. But I acquired my sense of fun from my father, a warm-hearted person who loved to make people laugh and feel better about themselves. I grew up in a household where the Marx brothers, Chaplin, the Rat Pack, Buster Keaton, Laurel and Hardy and many others were a big influence. I would love to have studied drama, but paradoxically this would have been highly unacceptable to my parents and even to myself. How would I have made a living? Know any famous South African actors? Any that make a living? Exactly! So I didn’t even consider the possibility. Drama was a recreation, not a profession – end of story.

When I came to London in 1982, I allowed myself to indulge in a lot of theatre and stand-up comedy. I was enthralled but thought of myself as a merely a punter. One day I recognised a stand-up comedian I had admired on stage in a London teashop. He was the laconic Arnold Brown and we soon became friends. We struck up a deal. He could visit me for free medical advice whenever he wanted. In exchange he would take the stress out of my day by making me laugh! We both thought we had a good deal and perhaps we did. We started to chat about the links between laughter and health. Laughter has been proved to reduce muscular tension, increase immunity, help the lungs get rid of old air and reduce stress. In addition it is a good form of exercise and gives you a natural high by raising your endorphins and encephalins, the ‘feel good’ chemicals of the body!

Together with the improvisational comedian, Neil Mullarkey, we eventually formed the Academy of Laughter &Health. After rehearsing for a year we put on a review at a London fringe theatre. ‘Are you feeling Funny?’ Explorations into health humour and chutzpah was performed for two nights at the New End Theatre in Hampstead. I performed under the stage name of Dr. FishHead and received a good review in the Evening Standard. I felt elated, far prouder than I had felt after passing any number of difficult exams at university.
Finally, I’d summoned up enough courage to follow my gut feeling and do what felt right for me. It’s important to live like this, whatever others think; but life is much easier when others approve!

My interest in laughter and health continued and I met the famous doctor/clown, Patch Adams, later immortalised by Robin Williams in the film, Patch Adams. The author Howard Jacobson attended a seminar on the subject run by Arnold and myself and wrote about us in his excellent book Seriously Funny on the ways that humour has always been healthy for any society.

Provocative Therapy (Provoking people to help themselves)
In April 1996, a friend sent me a flyer advertising a seminar on the use of humour in psychotherapy. An American called Frank Farrelly was running it and the process was called Provocative Therapy. I went down to Surrey University for the weekend course, but within minutes of seeing Frank demonstrate Provocative Therapy, I had a tremendous sense of ‘coming home’. The various pieces of my life started to fit into place. It had all been a journey that was meant to arrive at that very moment; my experience of the ‘nowness’ of the moment was profound. Perhaps all moments are this sacred; we just don’t recognize them as such.

Frank was doing 20-minute modules with volunteers and of course I went on stage and had a session with him. I remember it well. He just used humour to strip away the false and leave me with the truth that was always within me. The next day I did a 3-minute exercise in the group and this was also a profound experience. This time my therapist was Phil Jeremiah, a psychiatric social worker from Birmingham. We hit it off immediately, became close friends and eventually formed BIPT, The British Institute of Provocative Therapy.

But what about homeopathy? I find working with Provocative Therapy completely compatible with using homeopathic remedies. Without knowing that I was a homeopath, Frank Farrelly told a story of a homeopathic doctor who came up to him after a seminar and said that Provocative Therapy was ‘homeopathic’. The patient presents the problem and the therapist ‘potentises’ it with humour and gives it back to the patient as a remedy. Did I need any more confirmation that I was in the right place at the right time? I became very enthusiastic about Provocative Therapy and was fortunate enough to have Frank Farrelly supervise my difficult cases. This was done by telephone across the Atlantic and called ‘snoopervision’ by Farrelly. Once again I felt privileged to be accepted as a pupil by a great master especially in a subject that totally suited my personality.

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After about five years of including Provocative Therapy into my practice, I realised that my education as a doctor started to make sense. Medical school was tough but would always be an excellent foundation on which to build and being a medical doctor would give kudos and credibility to future plans. Homeopathy was the perfect holistic tool to study as it taught me how to listen to peoples’ life stories and choose remedies based on their subjective experience of their symptoms and life rather than only on my own objective judgments. 15 years of listening to such stories helped me enormously in my training as a provocative therapist. One can only amplify and satirise dysfunctional behavioural patterns when one is very familiar with those patterns. Talking and listening to literally thousands of people’s life stories is the best way of acquiring that familiarity.

I also feel blessed to have been taught by some wonderful teachers. George Vithoulkas taught me a beautiful and pure form of classical homeopathy to which I will always remain true. Eric Ledermann gave me a central existential ethic with which to practise medicine. It was important for me to recall this when using Provocative Therapy. The purpose of psychotherapy is to make the unconscious conscience of the patient, conscious. Humour can strip away the false self, leaving the patient with a clearer view of his or her own conscience. This is obvious and simple and the reason why the real therapy in today’s society is happening in any place where one friend helps another laugh at how seriously he is taking his problems.

Recognition by my peers
And what about homeopathy? In February 2003 I was deeply honoured to be made a fellow of the Faculty of Homeopathy (FFHom). I had become a member when I passed the required examination in 1983. That was nothing; I’d always thrived on ‘exam nerves’. This was very different. This was a stated recognition of my work by my peers and I’d never experienced anything like it before. I’d always been the outsider, the schoolboy without ‘school spirit’, the medical student with ‘the wrong attitude’ and finally the doctor who went ‘alternative’. Now a distinguished group of my peers had decided that I deserved to be heard within their most inner circle. That sense of belonging meant a lot to me.

I will always use homeopathy; I’ve seen it do wonderful things and have total respect for it as a therapeutic tool. But for me it is not a philosophy in itself, but a very useful holistic medical intervention capable of stimulating the body to heal itself. As is Autogenic Therapy, acupuncture, nutritional medicine and Provocative Therapy. Not everyone is happy about me using Provocative Therapy. ‘Keep the day job!’ say some. ‘But you’re a good homeopath…’ say others. ‘Go for it!’ say the friends who sense my enthusiasm. I think I owe it to myself to give it my best shot.

I will also make myself available to teach homeopathy, preferably with the people who are co-writing this book! I’ve made good friends in homeopathy and met many inspiring homeopaths from all over the world at homeopathic conferences. I make a point of asking all of them how they got into homeopathy. Each has a story, a journey different to mine, but we always shared one thing in common. We had taken a leap of faith and followed where our hearts led us.